- Humana (Tallahassee, FL)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- CVS Health (Tallahassee, FL)
- …anywhere in the state of Florida. **Applicant must reside in Florida** . As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and… more
- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Sharecare (Tallahassee, FL)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- CVS Health (Tallahassee, FL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Humana (Tallahassee, FL)
- …as Interqual, etc.) **Preferred Qualifications** + Utilization Review/Quality Management experience + BA/BSN degree **Work-At- Home Requirements** + WAH ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more
- Lincoln Financial (Tallahassee, FL)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
- HCA Healthcare (Tallahassee, FL)
- …passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse - Surgery Center position and spend more time at the bedside ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- HCA Healthcare (Tallahassee, FL)
- …**Introduction** Do you have the PRN career opportunities as an Operating Room Nurse PRN-Surgery Center you want with your current employer? We have an exciting ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Evolent (Tallahassee, FL)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
- CenterWell (Tallahassee, FL)
- …and reliable transportation. + Two years as a Registered Nurse in a home care, with at least one-year of management experience preferred. **Scheduled Weekly ... patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission… more
- HCA Healthcare (Tallahassee, FL)
- **Description** **Introduction** Do you have the career opportunities as a(an) Manager Case Management you want in your current role? We invest in what matters most ... to nurses like you - at home , at work, and at every stage in your...needs. + Develops, initiates, and coordinates individual patient case management plans to ensure appropriate level of care across… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** + **Three years of… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... is acceptable for position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** + **Three years of… more
- HCA Healthcare (Tallahassee, FL)
- …and assess observation patients for appropriateness in observation status + Performs utilization management reviews and communicates information to third party ... what matters most to nurses like you - at home , at work, and at every stage in your...position if current and compliant** + **Certification in Case Management , Nursing, or Utilization Review, preferred** +… more
- Sharecare (Tallahassee, FL)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more